北京某三甲医院2006-2015年医疗锐器伤处置分析

Analyses of disposals of sharps injuries in a tertiary hospital from 2006 to 2015 in Beijing

目的分析北京某三甲医院医疗锐器伤的处置方式和费用的变化,为持续改进医疗锐器伤的重点人群监测、报告管理、暴露后应急处理成本效益分析等管理工作提供依据。方法选择2006年1月-2015年12月医院处置620次医疗锐器伤的全部登记数据,利用SPSS19.0对医疗锐器伤发生的次数及处置情况、暴露源的分布、处置锐器伤的费用进行描述性统计分析。结果该医院平均每年处置医疗锐器伤62次,十年中未发生因医疗锐器伤造成的医务人员职业感染;护士(46.2%)、年轻医务人员更容易发生医疗锐器伤,少数医务人员(8.3%)曾多次发生医疗锐器伤;各种暴露源中,乙肝最多(60.6%),暴露源不详的比例逐渐增多;医务人员在发生医疗锐器伤后,只需进行化验的比例呈现升高趋势,接种疫苗的比例呈现下降趋势;该医院处置医疗锐器伤的年均费用为21936.72元,次均费用为353.82元。结论加强重点人群的监测和医疗锐器伤的报告管理,规范应急处理,可以有效预防因医疗锐器伤导致的医务人员职业感染,具有很好的成本效益。

OBJECTIVE To analyze the disposal methods and cost of sharps injuries in a tertiary hospital in Beijing,so as to provide basis for the continuous improvement of the monitoring,reports management of key population,and the cost-benefit analysis after the emergency treatment of the sharps injuries in the hospital.METHODS The records of 620 cases of sharps injuries from Jan.2006 to Dec.2015 were selected,and descriptive statistical analysis of the number and disposition of sharp injuries,the distribution of exposure sources,and the costs of disposing of sharp injuries were carried out.RESULTS This hospital dealt with 62 sharps injuries per year on average,and there were no cases that got sick because of the sharps injuries in the ten years.The nurses（46.2%）and young medical staff were the major sufferers,and a small number（8.3%）of medical staff got the injuries for several times in the ten years.Totally 60.6% of the staff was exposed to HBV and more and more staff didn＇t know what they were exposed to.After getting sharps injuries,the percentage of getting laboratory test only was increased,and the percentage of getting vaccination had a downward trend.The hospital spent 21936.72 NCY annually on the injuries and 353.82 NCY for once injury.CONCLUSIONGiving more attention to sharps injuries of key population and reports management and standardizing the emergency disposals of the injuries can prevent the staff from getting sick because of the sharps injuries and has a good cost-effectiveness.